Billing Representative Ii

2 weeks ago


Conroe, United States Montgomery County Hospital District Full time

**TITLE**:Billing Representative II - Claim Representative
**DEPARTMENT**: Billing
**REPORTS TO**: Billing Supervisor
**FLSA STATUS**:Non-Exempt

**SUMMARY**

Verify patient’s insurance and demographic data, follow up on delinquent accounts, review payments received for correctness, and refund all inappropriate payments by performing the following duties.

**ESSENTIAL DUTIES AND RESPONSIBILITIES** **include the following:

- Comply with policies and procedures, including federal, state, and local statutes for all billing and reporting activities.
- Follow-up all outstanding third party claims by working rejects, remittance, and status reports timely and to a conclusion.
- Review and work accounts in hold queues due to deductibles or missing information and file claims within timely filing deadlines.
- Review and work denied claims as required to meet timely filing requirements and deadlines.
- Review and correct errors on electronic claims and paper claims prior to billing to ensure correct reimbursement.
- Complete or review all aspects of the Pre-Bill process using approved resources and document all updates and activity.
- Monitor credit balances and take appropriate action through either the appeal or refund process.
- Verify signatures documented on Patient Care Reports are valid prior to claim submission.
- Perform skip trace when necessary.
- Process daily credit card transactions.
- Perform all tasks assigned with mínimal errors while meeting department productivity benchmarks.
- Exercise initiative, judgement, and make decisions within the scope of assigned authority.
- Answer incoming calls and demonstrate professional, courteous customer service skills in all interactions.
- Other duties as assigned.

**SUPERVISORY RESPONSIBILITIES**
- This job has no supervisory responsibilities.

**MINIMUM QUALIFICATIONS**
- National Academy Ambulance Coding Certification (NAAC)
- One year certificate from college or technical school; or
- Two years related experience and/or training; or
- Equivalent combination of education and experience.

**SKILLS and KNOWLEDGE**

**CERTIFICATES, LICENSES, REGISTRATIONS**
- Maintain a current status for Certified Ambulance Coder Certification (CAC).
- Maintain current Texas Driver’s License.
- Remain insurable by the current insurance vendor of MCHD.
- CPR Certification
- Required NIMS Training as referenced in the Safety & Emergency Management Policy SEM 27-201

NOTE: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

**Physical Demand Category**:
**Medium Work**:Lifting 50 pounds maximum with frequent lifting and / or carrying of objects weighing up to 25 pounds.

**Audio-Visual & licensing Demands**:

- Vision (Avg)
- Hearing (Avg)

**Required License / Certification: Valid Driver's License**

**Specific Actions Required**: _In an eight hour day, this job may include:_
- Standing/Walking: Occasional
- Sitting: 6-8 Hrs
- Driving: Occasional

**Work Environment**: _This job may include:_
- Chemicals

**Repetitive Motions**:_This job will include:_
- Simple Grasping
- Fine Manipulation
- Pushing & Pulling
- Finger Dexterity

**MANEUVERABILITY**: _This job will require: Occasional_
- Bending
- Squatting
- Climbing
- Twisting
- Reaching



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